Provider Demographics
NPI:1578695714
Name:GAD, GAMAL ELDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:GAMAL
Middle Name:ELDIN
Last Name:GAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:32 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1718
Mailing Address - Country:US
Mailing Address - Phone:973-523-6830
Mailing Address - Fax:973-523-3145
Practice Address - Street 1:541 E 29TH ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07504-1813
Practice Address - Country:US
Practice Address - Phone:973-523-6830
Practice Address - Fax:973-523-3145
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA057838002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0174007Medicaid
NJ5620104Medicaid
NJ5620104Medicaid